Neurocrine Biosciences (NBIX) Stifel 2026 Virtual CNS Forum summary

Commercial performance and outlook

• Achieved over $2.8 billion in revenue last year, representing 22% year-over-year growth, with Ingrezza contributing $2.51 billion and 9% growth, and CRENESSITY reaching $300 million in its first year.

• Revenue diversification beyond Ingrezza reached 12% last year, positioning the company as a multi-product biopharma.

• Ingrezza guidance for this year is $2.7–2.8 billion, with double-digit volume growth expected and price per script relatively flat after a Q1 headwind.

• CRENESSITY captured 10% of the CH market in its first year, with strong reimbursement and persistence, and aims to further expand market share.

• Sales force expansion and new DTC campaign planned for 2026 to deepen prescriber engagement and drive growth.

Pricing, access, and regulatory environment

• Ingrezza faces a 4–5% price decline year-over-year due to expanded access, with a 10% net price per script decline in Q1, stabilizing in later quarters.

• Medicare plan negotiations for 2027 are ongoing, with expectations to manage through competitor MFP implementations in 2027–2028 and own MFP in 2029.

• 70% of TD and HD patients are under current contracts, providing strong access and stability for the year.

• Q1 typically sees reauthorization noise for Ingrezza and gross-to-net impacts for CRENESSITY, but both brands are expected to have strong years.

Pipeline and clinical development

• Multiple phase II and III readouts expected in 2027, including Osavampator and direclidine in neuropsychiatry, and NBI-570 (M1M4 dual agonist) in schizophrenia.

• Next-generation VMAT2 inhibitor (NBI-890) in phase II for tardive dyskinesia, with data expected in the second half of next year.

• AMPA-PAM program showed robust phase II efficacy and safety, with three phase III trials and a randomized withdrawal study reading out in the second half of 2027.

• Muscarinic pipeline includes dual M1M4 and M1 agonists for schizophrenia and Alzheimer's, with phase II trials ongoing and rapid advancement planned.

• Next-gen CAH program (NBIP-1435, a long-acting CRF1 antagonist) in phase I, with plans to move into phase II/III later this year.